The Denver Police Department is rolling out a program in which unarmed first-responder teams of paramedics and mental health professionals will start handling some low-level 911 calls that police would otherwise respond to. The program was inspired by a model called CAHOOTS (Crisis Assistance Helping Out on the Streets), which has been operating for thirty years in Eugene, Oregon.
Police Chief Paul Pazen presented the tentative plans for the program to a Denver City Council committee on November 6. According to Pazen, Denver has seen a 15 percent increase so far in 2019 in the number of people calling 911 because of a mental-health related reasons, such as suicide or other significant clinical disorders that are tracked by the 911 operator or responding officer. There has been a total of 26,509 such calls so far this year, already more than any of the three previous ones. Those numbers highlight the need for a new approach.
"We want to make sure that we can help people in need, and do this in the public health space and not the public safety space," he said.
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In June, a group of Department of Safety staff and community advocates visited Eugene and did ride-alongs with the CAHOOTS program. A working group is deliberating the details of what Denver's program will look like. A pilot version will begin soon — an exact timeline has not been determined — and will be concentrated in certain areas.
The idea got strong support from city council members, as well as criminal justice reform advocates and activist groups that work with the homeless and drug users. Community members who spoke at the committee meeting did have one big request: that the program be staffed and administered not by the city, but by a community-based nonprofit.
The social services organization Servicios de la Raza has been interested in creating a program like CAHOOTS for many years. To advance the idea, it formed a group called Denver Alliance for Street Health Response (DASHR), which has since also helped establish a restorative justice program in the city.
Roshan Bliss, co-chair of the Denver Justice Project, a group that works on police reform, has also been pushing Denver to adopt such a program. "Ideally, it would definitely be a community-based effort that partners with the Safety Department to use the 911 infrastructure," he says.
"Ideally, it would definitely be a community-based effort that partners with the Safety Department to use the 911 infrastructure," he says.
That's how Eugene's CAHOOTS program has worked, and Tim Black, the program's operations coordinator, says it's been crucial to its success. CAHOOTS is staffed and administered by the longstanding grassroots White Bird Clinic, which provides physical, emotional and social health services to low-income residents. The clinic originally operated its own crisis line, through which it sent medical and psychological professionals to help answer calls. It filled a niche in the community, but not everyone knew they could call the clinic.
"So many of us are conditioned from a very young age to call 911 when someone or something looks or feels wrong," Black says.
The clinic eventually partnered with the city to be able to respond to official 911 calls. "The joke was that all of a sudden, the hippies were in cahoots with the police," Black says.
But in Eugene, CAHOOTS staff members don't wear badges or carry any sort of self-defense weapons. They can call for police backup in case a situation escalates, but Black says they rarely have to do so.
Emergency operators decide whether to dispatch CAHOOTS, police or fire/EMS services. CAHOOTS teams are usually dispatched to situations involving a mental health crisis — for instance, a person threatening suicide, someone overly intoxicated or overdosing, or someone simply behaving in an odd way — that does not seem to threaten violence.
Instead of looking for violations of law, making arrests or running warrant checks, CAHOOTS teams are tasked with keeping the person safe. They use crisis de-escalation techniques to stabilize the situation, and then try to figure out how to help the person access long-term solutions. They also focus on building relationships: If a CAHOOTS team drives someone from a homeless shelter to the hospital, the same team will often pick that person up, drive them back, and ensure they still have a bed.
"There was a lot of talk about 'What does safety look like for you right now?' 'What does safety look like for you tonight?'" notes Lisa Raville, who went on the trip to Eugene as the executive director of Denver's Harm Reduction Action Center.
The community's trust in the White Bird Clinic is important to making the program work. "Even paramedics and fire are not who people want to see right away," Raville says. "Sometimes it's paranoia. Sometimes it's just trying to figure out what the fuck is going on. And when you have somebody with you saying, 'I'm here, I'm invested in your health and safety, and I want to know how I can support you right now,' that really builds trust right away with folks."
But in Denver, there's no perfect analog for the White Bird Clinic. Bliss says many grassroots direct service organizations will have to come together to make the program work. Bliss imagines the program could even recruit volunteers or employees with Wilderness First Responder training, college nursing students, and people with lived experience of addiction, incarceration or homelessness to help.
Pazen is supportive of the idea of community-based ownership of the future program. "This is a completely collaborative approach," he says.
Terese Howard, an activist with Denver Homeless Out Loud, says the program would be a huge step forward, since many homeless people have a strained relationship with law enforcement. At the committee meeting, she told a story of a woman she knew who was overly intoxicated and wanted to get into detox. Her husband called and asked for an ambulance, but police also showed up.
"He had a warrant, so he of course had to step out of the whole situation and couldn't advocate for her," Howard explains. "She had bad experiences with police and didn't want to interact with them, and was very stressed in the whole situation. And she ultimately didn't end up going to the hospital because of that."
Janet van der Laak said at the meeting that she believes an alternative crisis response team could make a huge difference for her son, Matt, who has chronic paranoid schizophrenia, a mental illness that renders him "kind, loving, and very docile," but also liable to find himself in situations where he has unknowingly broken a law or behaved in odd ways in public. Multiple times, van der Laak said, these encounters have resulted in police encounters, citations pr court dates that Matt may forget about, and eventually arrests. Multiple times, she said, he has languished in jail for months awaiting a competency evaluation, even though he has only ever received minor charges like trespassing, giving a false name to an officer, or low-level drug possession.
"He's terrified of police," van der Laak says now. "I think [CAHOOTS] would help, because it’s not somebody in uniform responding, it’s somebody in plain clothes. He’d be more willing to be open to services when it’s not forced.
"What I would like to see is the same people working in the same district so that they can develop that trust and rapport," she continues. That could help her son into the mental health treatment he desperately needs while also helping him avoid jail time, because instead of arresting him, the team "could just call me and say 'Matt’s over here, can you come pick him up?'"
According to Bliss, an alternative crisis-response program could also prevent even more severe consequences of escalating law enforcement encounters. According to a 2015 report by the Treatment Advocacy Center, an estimated 2 percent of Americans have a severe untreated mental illness; these individuals are disproportionately involved in police shootings, comprising 25 percent of the population killed by police. They also make up about 10 percent of law enforcement encounters in general.
"We have to make sure we're not treating public health issues as law enforcement issues,” Bliss says.
The working group plans to initially seek funding from the Caring 4 Denver initiative, a sales tax that Denver voted to adopt last year, and will put out requests for proposals in early 2020. Eventually, advocates could see it being partially funded by the Department of Public Safety itself, which as of now takes up by far the biggest chunk of Denver's general fund budget. That's how Eugene's CAHOOTS program works, and Black says it's an economical as well as effective approach. CAHOOTS gets only 2 percent of the budget but answers 17 percent of 911 calls.
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Denver is already one of eight counties that received state funding to implement "co-responder" teams in which a law enforcement officer and a behavioral health professional are dispatched together. Additionally, all officers are trained in crisis intervention.
Pazen asserts that the forthcoming program wouldn't replace these efforts, which the department has found valuable, but rather add to the options Denver has to respond to complicated emergencies. And if the program expands, it could free up police to focus on higher-level crimes.
"We have some pretty good things already, and we're just trying to build those things," he says.
Update, November 21: We have added information about DASHR, one of the original groups involved in pushing for the program.